Nerve Stimulation Technique for Bladder Symptoms

[Quest56]

A PubMed report describes a tibial nerve stimulation technique for the treatment of lower urinary tract symptoms of multiple sclerosis. Here's a link:

Nerve Stimulation for Treatment of Refractory Urinary Tract Symptoms of Multiple Sclerosis

Results: There was a significant reduction of daytime frequency (from 9 to 6, p = 0.04), nocturia (from 3 to 1, p = 0.002) and mean post-micturition residual (from 98 ± 124 ml to 43 ± 45 ml, p = 0.02). The mean voided volume increased from 182 ± 50 ml to 225 ± 50 ml (p = 0.003)...

Anyone have any experience with this?

--Tracy

[Quest56]

Here's a link to a wikipedia article that talks about this procedure:

http://en.wikipedia.org/wiki/Percutaneo ... timulation

From the article: "...methodology was first invented by Dr. Marshall Stoller at UCSF Medical Center, San Francisco, and was first known as the SANS protocol."

Procedure
A patient sits comfortably with the treatment leg elevated. A fine needle electrode is inserted into the lower, inner aspect of the leg, slightly cephalad to the medial malleolus. As the goal is to send stimulation through the tibial nerve, it is important to have the needle electrode near (but not on) the tibial nerve. A surface electrode (grounding pad) is placed over the medial aspect of the calcaneus on the same leg. The needle electrode is then connected to an external pulse generator which delivers an adjustable electrical pulse that travels to the sacral plexus via the tibial nerve. Among other functions, the sacral nerve plexus regulates bladder and pelvic floor function.

With correct placement of the needle electrode and level of electrical impulse, there is often an involuntary toe flex or fan, or an extension of the entire foot. However, for some patients, the correct placement and stimulation may only result in a mild sensation in the ankle area or across the sole of the foot.

The treatment protocol requires once-a-week treatments for 12 weeks, 30 minutes per session. Many patients begin to see improvements by the 6th treatment. Patients who respond to treatment may require occasional treatments (~ once every 3 weeks) to sustain improvements.

PTNS is a low-risk procedure. The most common side-effects with PTNS treatment are temporary and minor, resulting from the placement of the needle electrode. They include minor bleeding, mild pain and skin inflammation[6].

Not a permanent fix for the problem, of course, but it looks like it could bring some definite symptomatic relief (sound familiar?).

--Tracy

[Loobie]

I will be taking this to my physiatrist. Thanks Tracy!

[Quest56]

A Percutaneous Tibial Nerve Stimulation technique to treat overactive bladder symptoms (pubmed and wikipedia reports about the technique were given in an earlier post) is code-named uroplasty, and is described at this website:

http://www.uroplasty.com/

I discussed this with a Urologist yesterday, and found out that he uses the technique successfully to treat overactive bladder symptoms. There is a link at the site above that you can use to find a doctor that uses the technique.

I hope to start treatment soon, his office is first working to determine if my insurance will cover the cost.

I look forward to finding an additional technique to treat OAB symptoms. I'm working through Detrol side-effects right now, and hope to start uroplasty treatment soon.

Anyone else have experience with this?

--Tracy

[vesta]

It sounds to me like stimulation of the Kidney Meridian which is the Yin Partner to the Bladder meridian in Chinese Acupuncture treatment. It may be self acupressure treatment of the Kidney and Bladder meridians may be equally effective. I use self acupressue daily to keep in shape. See MS Cure Enigmas.net Blog posts Acupuncture or Self Acupressure

[stazmatic]

If anyone tries this treatment for their bladder, please let us know how well it works for you. Thanks OP for sharing this info!

[Quest56]

If anyone tries this treatment for their bladder, please let us know how well it works for you. Thanks OP for sharing this info!

I found this treatment to be very helpful in reducing overactive bladder symptoms. But, in my case, trouble was I needed to get weekly treatments to maintain the benefit, and Medicare would only cover a limited number of treatments per year, far less than 52.

So, I'm back on tolterodine to help manage these symptoms (1mg three times per day).

I'd be more than willing to purchase a PTNS stimulation unit and learn the acupuncture technique to treat myself, but the maker of the unit will only sell to MDs.

--Tracy

[ljelome]

Hi! besides PTNS maybe u could also try kegel exercise to build up the strength of your pelvic muscles floor, n scheduling your water consumption so within every hour u would have the same amount of water intake. It can be used to train your bladder to urinate at the time it supposed to be.

I guess the second have helped me in controlling my urination time to be less frequent n also based on how much the water intake i already had.

And for the urine retention, i found that the urinating position is also important. I found squatting is a more effective position for me and then give yourself time to stand up for a couple minutes (i usually have to stimulate my bladder by pressing my stomach, i do it several times when i am standing) n then i go squat again while trying to urinate. I repeat these movements untill no more urine can go out.

That's from my experience (i have some bladder problems like urinary incontinence, urgency to go to the toilet, frequent urination n urinary retention). Good luck.

[Quest56]

An article about this technique in today's Science Daily newsletter:

http://www.sciencedaily.com/releases/20 ... ce+News%29

--Tracy

[blossom]

maybe this can help and explain more? or at least the acupuncture thoughts. checked the site there are no dr.'s even close and in my area a good acupuncture practicioner can't be found i located wanna b's. but maybe others will have better luck i hope.
thanks for the new info. questor.

http://www.acupuncturemoxibustion.com/c ... e-bladder/

[vesta]

One can buy an electric stimulator TENS (Transcutaneous Electrical Nerve Stimulator) by mail for about $50 plus extra for pads, and treat oneself. The http://www.Uroplasty site shows the points they are using, blossoms site discusses others. No reason to be defeatist, there is much one can do oneself. It depresses me to see Western medicine take an ancient knowledge (Acupuncture) and translate it into some expensive exclusive treatment, need for insurance etc. And people feel they need an "expert" to do something they can well do themselves, or at least TRY. Electrically stimulated Acupressure works.

MS Cure Enigmas.net

[Quest56]

One can buy an electric stimulator TENS (Transcutaneous Electrical Nerve Stimulator) by mail for about $50 plus extra for pads, and treat oneself.

Vesta,
I have a TENS unit, but do not know the frequency or wave-form found to be efficacious in the PTNS published result, also the needle for the technique is inserted quite deep into the lower shin to be in close proximity to the tibial nerve, so I am not interested in experimenting with doing this myself. It isn't pleasant if the needle accidently hits the tibial nerve.

I've had many acupuncture treatments for many MS symptoms over the years, but have never felt any long-lasting benefit or change in disease progression (this has become increasingly evident as MS and its symptoms have progressed and become more of a problem for me). Also, insurance coverage is spotty for acupuncture, and is non-existent now that I'm on Medicare. I have never experimented with acupressure treatments.

Blossom, I last received PTNS treatments from a urologist in my area, he was trained by the company that markets the PTNS device, and was very familiar with the potential benefits to be had for over-active bladder problems.

I am currently working with an MD who specializes in functional medicine and is trained as an acupuncturist, she has the necessary equipment and has been in contact with other doctors to obtain the specs for this form of treatment. She is also willing to teach me to do these treatments on myself using a TENS unit, so this may happen at some point in the future. Time will tell.

And for the urine retention, i found that the urinating position is also important. I found squatting is a more effective position for me and then give yourself time to stand up for a couple minutes (i usually have to stimulate my bladder by pressing my stomach, i do it several times when i am standing) n then i go squat again while trying to urinate. I repeat these movements until no more urine can go out.

ljelome, you are lucky to have found a technique to use to empty the bladder. I also use the manual pressure technique to start flow, but I am not able to fully empty my bladder without using a catheter, which I use when I first wake up and before going to bed. I typically retain about 120 ml of urine even after emptying as much as I can by jumping up and down and using manual pressure.

--Tracy

[vesta]

Hi Questor:
Acupuncture early on could stop an MS attack for me, I assume because it stopped the blood reflux and enhanced blood circulation. However, I continued to go downhill. It was the detoxification and diet change/optimal nutrition which healed me (and when I started eating glutens again and neglected the diet the MS resumed.) So I'm not saying acupuncture will heal MS, there is more to it, and obviously one can't get treated every day. However, when I learned about the liberation therapy blood reflux idea (summer 2010) I started to give myself TENS treatment on Acupressure points (GB34 or GB21 and Sp6 or Sp9) and by the next day the attack had stopped in its tracks. I now treat myself every day to get the blood circulating. Had I known this 20 years ago I'm convinced I wouldn't need a cane to walk today. At the moment I treat myself, no great OBVIOUS improvement, except for a mood change but I'm quite certain that the blood circulates better (I feel that during the night it stagnates from the head.) I could kick myself because I had the unit and didn't believe it would help me so just left it in the closet. I don't pay attention to frequency etc, probably should but it works anyway. But my suggestion is to try to treat yourself without the needle, and if your acupuncturist can locate the point (let me know the point's name if you can) I so no harm in trying.
Also, to find the acupuncture point for bladder release, put the thumb in the navel, finger at the top of the pubic bone and press about a quarter of the way up from the pubic bone. (The acupuncturist should be able to show you.)

MS Cure Enigmas.net

[Quest56]

So I'm not saying acupuncture will heal MS, there is more to it, and obviously one can't get treated every day. However, when I learned about the liberation therapy blood reflux idea (summer 2010) I started to give myself TENS treatment on Acupressure points (GB34 or GB21 and Sp6 or Sp9) and by the next day the attack had stopped in its tracks.

Vesta, thank you for this information. I'll take it to my primary acupuncturist (also my Better Half) to learn the location of these points and give it a try with the TENS unit.

Best regards...

--Tracy

[Quest56]

http://www.ncbi.nlm.nih.gov/pubmed/24387787